Thu Sep 09 2010
DEAR DR. GOTT: I am a 72-year-old male. I had colon cancer in 1990 and a serious heart attack in 1995. I started cholesterol medication shortly after that, until two years ago, when I started having leg cramps, weak muscles and sore ankles so bad I could no longer walk without a cane. I had tried every cholesterol medication available. I convinced my cardiologist to drop all cholesterol medication. I am happy to report I can walk again. I take omega-3 fish oil and feel great. My only question is, if statins damage muscles, what does it do to the heart? It is also a muscle.
DEAR READER: Good question. I don't know the answer. To my knowledge, the muscle damage that is occasionally the result of therapy with statin drugs does not affect the heart.
The primary consequences of rhabdomyolysis (the muscle damage to which you referred) are muscle pain and weakness. However, as the damage progresses, the protein that is released by the damaged muscles circulates in the blood stream until it is removed by the kidneys and excreted. A massive amount of protein may be more than the kidneys can tolerate. In this situation, which resembles a storm drain in a flood, the kidneys themselves may become blocked, an exceedingly dangerous situation.
I doubt that you have suffered permanent damage. But I endorse your position regarding the unwanted effects of statin drugs, and I applaud your steadfastness in following a sensible medical path. I also should give credit to your doctor, who had the sense to listen to you.
You mentioned in your letter that you are 72 years old. Given your involvement and experience with the medical profession -- plus what is probably a relatively feisty attitude -- you will surely live at least another 20 years, during which you might well have earned the title of "Cranky Yankee," the label with which I bless my own wonderful, aging patients.
DEAR DR. GOTT: My daughter is addicted to Afrin, as many others are. Her doctor is casual about this situation. What are the effects of this? Where should she go for help?
DEAR READER: As is true with many types of nose spray, Afrin can cause a congestive condition called "rebound" if used for more than a few days at a time.
You don't say the reason your daughter is misusing Afrin. If she simply has nasal congestion, a daily lavage with saltwater might help her. Or, if she has allergies, an oral antihistamine, such as Claritin, could lessen her congestion.
In either case, I recommend that she stop using the Afrin; that act by itself could solve her problem.
DEAR DR. GOTT: Do you know the long-term effects of an allergen on the lungs if symptoms go untreated? Example: Someone who is allergic to cats but lives with one and takes no medication to reduce symptoms (asthma, wheezing, coughing, stuffed-up nose).
DEAR READER: The consequences of continuing exposure to allergens can vary tremendously. Acute allergic reactions can be fatal. Inhaled allergens can lead to chronic asthma (cough, wheezing, difficulty breathing, etc.) and associated lung damage, such as chronic bronchitis, emphysema and others.
In most cases, patients allergic to animal dander have chosen to place their pets in other families.
The use of antihistamines and appropriate therapy for asthma will often improve the quality of life for older allergic adults.
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